Gary M Goldbaum, MD, MPH

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00023980 Issued in WA

Practice address

3020 Rucker Ave
Everett, WA 98201-3900

Phone

(425) 339-5210

Fax

(425) 339-5216

NPI assigned

Jan 23, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1881748127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013900",
            "telephone_number": "425-339-5210",
            "fax_number": "425-339-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013900",
            "telephone_number": "425-339-5210",
            "fax_number": "425-339-5216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBAUM",
        "first_name": "GARY",
        "middle_name": "M",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00023980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8106411",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April Audrey Goff
• Robert Lamar Goff Jr.
• Julie Golbek, ARNP
• Caitlin Elizabeth Golberg, OD
• Julie Marie Gold, R.T.(R)
• James Goldberg, MD
• Raymond Alan Golden, HM
• Deidre Lorene Golej, PHARMD, PHD
• Jaymar Vincent Golveo, DDS
• Ashlee Gomez, LMP

• Family Medicine Physician in Everett, WA
• Providers in Everett, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.